title: Assessment of deoxyribonucleic acid fragmentation index, testicular volume, semen parameters, and hormone profile in gonadotropin-treated men with hypogonadotropic hypogonadism.
abstract: OBJECTIVE
  To study the sperm deoxyribonucleic acid (DNA) fragmentation index (DFI), testicular volume, semen parameters, and hormone profile in human chorionic gonadotropin (hCG)- and human menopausal gonadotrophin (hMG)-treated patients with hypogonadotropic hypogonadism (HH) with and without a successful pregnancy.
  
  
  METHODS
  This is a cross sectional study. The study initially included 81 patients with HH and azoospermia at the Infertility Unit of Royan Institute between 2010 and 2012. Fifty-eight of 81 patients achieved >1 × 10(6) sperm/mL during hCG and hMG therapy. These 58 patients were divided into the following 2 groups: 20 patients with HH who achieved pregnancy in response to hCG/hMG (responders, 16 naturally and 4 by intrauterine insemination) and 38 gonadotropin-treated patients with HH with failed pregnancy (nonresponders, 29 naturally, 5 by intrauterine insemination, 1 by in vitro fertilization, and 3 by intracytoplasmic sperm injection). Sperm DNA fragmentation was visualized by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay.
  
  
  RESULTS
  Average of DFI (responders: 13.45 ± 0.64; nonresponders: 21.92 ± 0.86), age, body mass index, testis volume semen parameters, and follicle-stimulating hormone, luteinizing hormone, and testosterone levels in the 2 groups were calculated. Cut-off point for DFI was determined by receiver operating curve analysis (17.5%).
  
  
  CONCLUSIONS
  It was shown that DFI in responders is significantly lower than DFI in nonresponders (P <.001), and duration of hCG and hMG therapy in responders is significantly higher than those of nonresponders (P <.05). DFI could be predictive of conception (P <.001; odds ratio 0.57; 95% confidence interval 0.417-0.778). It can be concluded that despite low sperm quality, especially sperm concentration in these patients, decreasing sperm DNA damage may result in successful fertilization.
authors.affiliation: Department of Andrology, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, Academic Center for Education, Culture and Research, Tehran, Iran.
authors.forename: Hani
authors.initials: H
authors.lastname: Hosseinifar
authors.forename: Marjan
authors.initials: M
authors.lastname: Sabbaghian
authors.forename: Mohammad
authors.initials: M
authors.lastname: Chehrazi
authors.forename: Tahereh
authors.initials: T
authors.lastname: Modarresi
authors.forename: Firouz Jannat
authors.initials: FJ
authors.lastname: Alipour
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Sadighi Gilani
mesh_terms: D003430:Cross-Sectional Studies; D004249:DNA Damage; D053938:DNA Fragmentation; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy* / Q000473:pathology; D020287:In Situ Nick-End Labeling; D008297:Male; D008596:Menotropins / Q000627:therapeutic use; D009929:Organ Size / Q000187:drug effects; D013091:Spermatogenesis / Q000187:drug effects; D013094:Spermatozoa; D013737:Testis / Q000473:pathology
chemical_list: D005300:Fertility Agents, Female; D008596:Menotropins